Combined envelope and statement form



" June 14, 1966 s. J. BLACK 3,255,952

COMBINED ENVELOPE AND STATEMENT FORM Filed y 1954 3 Sheets-Sheet l l0 52 lo r AJAX LUMBER COMPANY d 7 H19 suPREME E. "iv

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O L Lu 0 M O 5 DATE REFERENCE CHAR CREDITSBALA H J, a? 3'!l r w w w W fi [ZCJAX EMFERYofi/xm 35 I we SUPREME AVE I 35 TORONTO, ONT. J L .4 I f PAY LAST+ AMOUNT IN THIS COL.

INVENTOR SYDNEY J. BLACK AT TORNEY June 14, 1966 5. J. BLACK 3,255,952

COMBINED ENVELOPE AND STATEMENT FORM Filed July 30, 1964 5 Sheets-$heet 2 INVENTOR SYDNEY J. BLACK ATTOR EY June 14, 1966 5. J. BLACK 3,

COMBINED ENVELOPE AND STATEMENT FORM Filed July 50, 1964 3 Sheets-Sheet 3 g AJAX LUMBER COMPANY FROMmrq supnzmemzflbx t 6 S.J BLACK IO KINGSWAY CRES,

GRIMSBY, ONT. J

DATE AMT- RECD SIGNATURE I DATE REFERENCE CHARG- CREDIT BALANX PAY LAST FIG-8 INVENTOR SYDNEY J. BLACK ATTORNEY United States Patent 3,255,952 COMBINED ENVELOPE AND STATEMENT FORM Sydney 1. Black, Grimsby, Ontario, Canada (126A Glen Road, Toronto 5, Ontario, Canada) Filed July 30, 1964, Ser. No. 386,171 1 Claim. (Cl. 229-73) This application is a continuation-in-part of the copending application having the Serial Number 171,716 and filed on February 7, 1962, now US. Patent No. 3,143,279, by the same inventor.

The present invention relates to a form for statements of account, more particularly, to a combined envelope and a statement form which includes on a single sheet a customers envelope, a statement, a reply envelope and a window panel.

Many forms of envelopes have been devised which have both an address portion for the customer and a reply address portion, and such envelopes may be folded so that either address portion may appear on the outside of the envelope. Envelopes with window panels have been commonly used so that the address of the customer on the statement in the envelope is Visible through the window. Other forms of envelopes have been provided having a separable check attached to the statement part, but these envelopes have the disadvantage that the statement part is too short so as to be reproduced from a conventional ledger card. Such envelopes have a further disadvantage that the customers name and address must be written or typed twice, and when the check is returned, the mailing piece comprises only two folded parts one of which is the check itself. Accordingly, there is no protection for the check.

It is therefore the principal object of the present invention to provide a novel and improved combined envelope and statement form.

It is another object of the present invention to provide a combination envelope and statement form that eliminates the use of separate envelopes for forwarding the statement to the customer and the payment of the account by the customer.

It is a further object of the present invention to provide a combination envelope and statement form suitable for mailing, wherein all the parts are integrally connected for folding into different positions depending on who is to receive the form.

An additional object of the present invention is to provide a combination envelope and statement form onto which a ledger card with the name and address and account of the customer can be automatically reproduced from the original ledger card in one simple operation so as to eliminate any possibility of mistake in transferring the data on the card to a statement.

It is still another object of the present invention to provide an efficient and economical combination envelope and statement form that does not require the need to be separately addressed.

Still a further object of the present invention is to provide a combination envelope and statement form which includes a reply envelope which can be formed by the customer with a minimum of effort.

The foregoing objects are attained and the disadvantages of the prior art are eliminated by the present invention which essentially comprises a combination envelope and statement form which includes a billing envelope, a statement, and a reply envelope integrally formed on a single sheet. Sufficient space is provided on the inside of the form for the reproduction thereon of the ledger card of the customer by conventional reproduction machines, thus eliminating the additional typing of the name, address and account of the customer. For ready access, account ledgers are commonly provided with the name and address of the customer at the top thereof. These ledger cards are of a convenient length in order to provide for as many postings as possible. The combination envelope and statement of the present invention has suificient length to permit the complete copying of the statement from the ledger copy.

The combination form comprises a rectangular sheet which can be folded along a number of transverse fold lines into four parts. The uppermost part of the form has the customers name and address thereon, the next succeeding parts below it have the statement of account reproduced or written thereon if automatic reproduction is not desired, and the lowermost or fourth part below the statement contains a window panel throughnwhich the customers name and address on the upper part is visible when the form is folded. Below the window part is a gummed strip for sealing the envelope when the form is folded. The upper edge of the inner face of the window panel part is provided with a gummed strip and a'perforated line so that when the bottom part. of the window panel part is torn off by the customer, a flap is formed which is used to seal the form by the customer when remailing to the reply address.

The uppermost part of the form which has the customers name and address thereon has a row of punched holes along the marginal edges thereof through which the statement parts may be secured together in order to form a completely sealed envelope for holding a check in payment of the account. It has been discovered that about of the customers prefer to enclose their own bank checks in payment of their accounts. The lowermost part of the two statement parts has on the front or inner face thereof gummed strips on both marginal edges so that the outer marginal edges of the reply form may be sealed through the punched holes described above in order to form the envelope.

The same form may also be used to send an indication of receipt of payment back to the customer. This is accomplished by providing a die cut portion in the upper statement portionwith the reply address being on the back of this die cut portion. The die cut portion is out along only three sides so that the reply address may be folded against the statement in order to leave an opening in the statement part. Thus, when the form is folded, the customers name and address appearing on the customers name and address part is visible through the opening in the statement part and the combined form can be mailed back to the customer. Receipt of payment may be stamped on the customers name and address portion.

Other objects and advantages of the invention will be apparent from the accompanying description when taken in conjunction with the following drawings wherein:

FIGURE 1 is a plan view of the inner face of a combination envelope and statement form in the opened position;

FIGURE 2 is a plan view of the outer face of the combination envelope and statement form of FIGURE 1;

FIGURE 3 is a perspective view of the combination envelope and statement form folded to be mailed to the customer but not sealed;

FIGURE 4 is an end view of the combination of the envelope statement form, as shown in FIGURE 3, when it is folded and sealed;

FIGURE 5 is a perspective view of the combination envelope and statement form folded to be mailed by the customer after removal of window part but not yet sealed;

FIGURE 6 is an end view of the combination form shown in FIGURE 5 when folded and sealed;

FIGURE 7 is a perspective view of the combination envelope and statement form as it is received by the reply addressee and illustrating the cutting operation in opening the envelope;

FIGURE 8 is a plan view of the inner face of the combination envelope and statement form opened after the cutting and opening step of FIGURE 7;

FIGURE 9 is a perspective view of the combinat on envelope and statement form of FIGURE 8, but showing the window panel Opening on the bottom; and

FIGURE 10 is a perspective view of the combination envelope and statement form of FIGURE 8 folded and showing the customers name and address through the window.

With particular reference to FIGURES l and 2, the combination envelope and statement form of this invention comprises a rectangular sheet 1 having transversely extending fold lines 2, 3, 4, and 5 thereon. The inner face of the form, as shown in FIGURE 1, is divided by the above-mentioned fold lines into a customers name and address part 6, a first statement part 7, a second statement part 8, and a window part 9. The customers name and address part 6 which is enclosed by the upper edge and the fold line 2 has the customers name and address 11 thereon as reproduced from the ledger card or by a separate writing operation.

The statement parts 7 and 8 which are enclosed by the fold lines 2, 3 and 4 contain the statement, as preferably reproduced in full from the ledger card of the business firm.

The window part 9 is enclosed between the fold lines 4 and 5 and has a window opening 16 therein through which the customers name and address 11 on part 6 will be visible when the form is folded for mailing.

The outer face of the form, as shown in FIGURE 2, is divided by fold lines 2 through 5 into a blank part 17, a reply address part 18, a second blank part 19, and a window part 20.

There are gummed strips 27 along the marginal edges of the statement part 8, and there is a transverse gummed strip 28 on the window part 9 adjacent the fold 4. Immediately below the gummed strip 28 is a perforated line 29 to facilitate removal of the major portion of the window part 9. A gummed strip extension 38 is provided on the lower end of the form extending from the fold line 5. This extension 30 is provided with a gummed strip 31.

Proceeding next to FIGURE 3, the combination form of this invention is shown being folded so as to be ready to 'be mailed to the customer.- The form, as shown in FIGURE 3, is first folded along the fold line 3 so that the parts 6 and 7 overlap the parts 8 and 9. The customers name and address of part 6 is then folded at 2 over the statement part 7 and the window part 9 is folded at 4 over the customers name and address part 6. The gummed strip 31 on the extension 38 is then folded over the parts 7 and 8 over the fold line 3 and fastened to the adjoining edge of the blank part 19, as shown in FIGURE 4.

The form is received by the customer in the folded condition illustrated in FIGURE 4. On receipt by the customer, the gummed strip 31 is broken and the window part 9 is detached along the perforation 29. The state ment on parts 7 and 8 is then examined so that the customer may ascertain the status of his account. To facilitate the sending of a check by the customer in payment on account, the customers name and address of part 6 is folded inwardly along the fold line 2 onto the statement part 7. The statement part 8 is then folded over onto the overlapping parts 6 and 7 and the gummed strips 27 pressed to seal the marginal edges of the reply envelope. The check or any other papers is then inserted inside the envelope thus formed and the gummed strip 28 is moistened and folded over onto the adjoining edge of the first blank part 17 to seal the envelope. The sealed envelope will then take form, as shown in FIG- URES 5 and 6.

The customers name part 6 is provided with rows or" punched holes 32 along the marginal edges thereof, as may be seen in FIGURES l and 2. The gummed strips 27 of the statement part 8 may be covered with protective strips 33 which are removed by the customer when folding the form into an envelope.

In forming the envelope from this combination form, the parts are folded together as described and illustrated in FIGURES 4 and 5. By merely folding the parts together the adhesive of the gummed strips 27 will pass through the punched holes 32 and will secure the statement parts 7 and 8 together with the name and address part 6 therebetween. In this exemplary embodiment of the invention, it is preferable that the adhesive strips 27 on the marginal edges of the statement part 8 comprise a pressure-sensitive tape.

When the customer forms the envelope, for return with the remittance the wide flap 34 is folded over in the same manner as illustrated in FIGURES 5 and 6. The required postage stamp and the return address of the customer may then be placed in the designated areas on the wide flap, as shown in FIGURE 2.

The combination form includes a further feature which enables the form to be used for remailing back to the customer with receipt of payment indicated on the form. As may be seen in FIGURES 1 and 2, the reply address 18 which appears on the reverse face of the statement part 7 is printed upon a flap 35 which is formed by die cuts 36 about three sides of a rectangular sheet so that the flap 35 is attached to the form along a fold line 37. This type of form enables the form to be mailed a third time whereby receipt of payment is indicated to the customer. The first mailing of the form from the firm to the customer is done in the manner as described above. The second mailing from the customer back to the reply address or the firm, and including the payment on the account, is similarly carried out as described above, with the wide flap 34 carrying the address and the necessary postage.

The customers name and address of part 6 which is enclosed by the upper edge 10 and the fold line 2 has the customers name and address 11 thereon as reproduced from the ledger card or by a separate writing operation.

The window part 9 is enclosed between the fold lines 4 and 5 and has a window opening 16 therein through which the customers name and address 11 on part 6 will be visible when the form is folded for mailing.

Proceeding next to FIGURE 3, the combination form of this invention is shown being folded so as to be ready to be mailed to the customer. The form is first folded along the fold line 3 so that the parts 6 and 7 overlap the parts 8 and 9. The customers name and address part 6 is then folded at 2 over the statement part 7 and the window part 9 is folded at 4 over the customers name and address part 6. The gummed strip 31 on the extension 30 is then folded over the parts 7 and 8 over the fold line 3 .and fastened to the adjoining edge of the blank part 19, as best shown in FIGURE 4.

The form is received by the customer in the folded condition illustrated in FIGURE 4. On receipt by the customer, the gummed strip 31 on the back of extension 30, is broken and the window part 9 is detached along the perforation 29. The statement on parts 7 and 8 is then examined so that the customer may ascertain the status of his account. To facilitate the sending of a check 'by the customer in payment on account, the customers name and address part 6 is folded inwardly along the fold line 2 onto the statement part 7. The gummed strips 27 on statement part 8 are prepared in a conventional manner. The statement part 8 is then folded over onto the overlapping parts 6 and 7 and the gummed strips 27 pressed to seal the marginal edges of the reply envelope. The check or other desired business papers are then inserted inside the envelope thus formed and the gummed strip 28 is folded over onto the adjoining edge of the first blank part 17 to seal the envelope. The sealed envelope will then take the form, as shown in FIGURE 6. In FIGURE 6 flap extension 34 of blank of part 19 is folded back upon reply address part 18 so that the gummed strip 28 will be secured to part 18 as shown.

When the form with payment is received by the firm the wide flap 34- is first opened, as shown in FIGURE 7 of the drawings. The marginal edges are then cut off, as indicated at 38 and 39 also in FIGURE 7, by scissors, a trimming board or any other suitable cutting device. By cutting off the edges in this manner, the form can be fully opened into a flat position, as shown in FIG- URE 8 of the drawings, and the payment therein may be removed. The amount of payment is then credited to the account of the customer and the receipt of payment is indicated on the customers name and address portion 6, at 40. The receipt of payment portion 411 may either comprise printed material with pertinent data to be filled in by hand or typewriter, or may comprise stamped information as may be obtained from suitable ofiice machinery.

For the third mailing of the form, i.e. back to the customer with the indication of receipt of payment, the connecting portions along the guide cuts 36 are broken by finger pressure and the flap 35 folded-back against the statement part 7. Thus, when the customers name and address part 6 is folded against the statement part 7 in the manner as described above, the customers name and address will be visible through the opening 41 formed by folding back the flap 35. The second statement part.

8 is then folded over onto the exposed blank part 17 to complete folding of the form. A staple may then be used to secure the form together by applying the staple along the edge 42, at 43.

It is apparent that when the wide flap 34 is removed upon receiving the payment from the customer, the stamp and return address are also removed. Accordingly, the same folded form used to mail the payment is free of any stamp and can accordingly be used for mailing the receipt back to the customer.

Instead of stapling, it may be desired to provide a gummed strip 44 along the bottom edge of the statement part 8, as indicated in FIGURE 8.

When the receipt is received by the customer and the envelope opened by removal of the staple or breaking of the gummed strip adhesive, the body of the statement is still clearly readable. When the die cut flap 35 is folded back into its original position, the statement or any other information thereon is still clearly readable since no portion of the statement was actually removed by the die cutting to form the flap 35.

As a further modification, the return address of the firm may be printed on a single line at 45 just above the customers name and address so that this return address is also visible through the opening 41 when the receipt of payment is mailed back to the customer. The customers name and address and the return address of the firm may be seen through the opening 41, as shown in FIGURE 10.

Thus it can be seen that the present invention provides a novel and improved combination statement and envelope form which enables the form to be used in three mailings, namely, mailing of the statement to the customer, mailing of payment by the customer to the firm, and mailing receipt of payment back to the customer. The simple structure of this form eliminates any necessity for complicated instructions to the customer for using the form. Further, it is not necessary to do any folding of margins to form an envelope in which payment is to be enclosed.

It will be understood that this invention is susceptible to modifications in order to adapt it to different usages and conditions, and accordingly, it is desired to comprehend all such modifications of this invention as may fall within the scope of the appended claim.

What is claimed is:

A combination envelope, statement and return form comprising a rectangular sheet having transverse fold lines for folding said sheet into four substantially equal parts; one face of said sheet being divided by said fold lines into a customers name and address part, two statement parts and a window part; the reverse face of said sheet being divided by said fold lines into a first blank part, a reply address part, a second blank part and a window part, respectively; each of said parts being of equal width, with the marginal edges thereof being coextensive; said customers name and address part having rows of punched holes adjacent the marginal edges thereof; one of said statement parts having gummed strips adjacent the marginal edges thereof; a transverse perforated line on said window part spaced from the adjoining statement part to define a flap adjoining said statement part; a gummed strip on said one face of said flap; a fold line on the end of said window part to define an extension thereon with a gummed strip on said extension on said one face thereof; said customers name and address part being folded over and superposed on said window part and said statement parts being folded over onto said first blank part with said gummed extension adhered to the adjoining edge of said second :blank part to secure the parts for the first mailing to the customer; said form being adaptable for the second mailing to the reply address after the parts are unfastened and inspected by the customer by detaching said window part along its transverse perforated line, folding the customers name and address part against the adjoining statement part, folding the second statement part against the reverse face of said customers name and address part so that said parts are adhered together by the gummed strips on the marginal edges of a statement acting through the punched holes on said customers name and address part, and the gummed flap being adhered to the adjoining edge of said reply address part, said parts being secured for remailing; a portion of said reply address part having the reply address thereon ibeing die out along three sides so that said die cut portion can be folded back to expose the customers name and address through the window on said window part when returning the form to the customer for the third mailing.

References Cited by the Examiner UNITED STATES PATENTS 2,773,638 12/1956 Krohn 22992. 2,964,233 12/1960 McFarland 22973 3,143,279 8/1964 Black 229-73 FOREIGN PATENTS 5,774 1913 Great Britain.

JOSEPH R. LECLAIR, Primary Examiner. FRANKLIN T. GARRETT, Examiner. D. M. BOCKENEK, Assistant Examiner. 

